RSV (Beyfortus) Product FAQs

What is it: Beyfortus®is a monoclonal antibody against Respiratory Syncytial Virus (RSV) that is indicated to avoid serious RSV infections in all infants. RSV is the #1 cause of infant hospitalization and peaks in late fall thru spring. This year’s RSV season begins 10/1/2023.

Who is it recommended for? Beyfortus® is recommended by FDA, CDC, and ACIP for all infants under 9 months of age entering their first RSV season. It is advised to give as close to birth as possible for infants born during the RSV season, and at the start of the season for infants born between February and October.

How is it given? It is a single injection given in the leg. It is a long-acting, passive immunity product. It offers protection immediately and should last for 6 months (ie the duration of the RSV season). Sapphire should have doses by October 1st, 2023.

Are there side effects? As Beyfortus® creates passive immunity and is not an active vaccine, there are no expected side effects, not even fever. It has been tested and can be given with any other childhood vaccine.  (read more here: www.Beyfortus.com)

We could not be happier this is available and are pleased to be able to provide early access!! 

BUT…

Commercial insurance is not yet providing coverage for Beyfortus®. 

While we do expect it will eventually be covered, there is no timeline or guarantee of eventual coverage. RSV season begins 10/1/2023, so time is of the essence. Sapphire wants you to have access to Beyfortus® as soon as we do, without regard to your insurer’s timeline.

(If your child is insured by Medicaid, your products will available by 10/1/23 and covered right away)

If you would like Beyfortus® NOW, there are 2 options for your commercially insured infant:

• Organize the dose on your own at your local health department as an ‘underinsured patient’ while your insurance coverage for the product(s) is pending. (you are considered underinsured if your insurance does not provide coverage for an ACIP recommended vaccine) Find your local health dept here
  • https://cdphe.colorado.gov/public-information/find-your-local-public-health-agency
• Pay out-of-pocket for Beyfortus® at Sapphire. You can submit the receipt to your insurer and may be reimbursed later. HSA eligible as well.
• Cost: $550/dose. Payment in full is due at the time of service. 
• You may also elect to wait until your insurance determines coverage. Sapphire has no control over the timeline, and while we expect coverage will eventually occur, it may be weeks or months or next season. 

Next steps for you: 

• Please message us via MyChart if you want to self-pay for Beyfortus®. 
• Speak with one of Sapphire's Pediatricians about your interest or questions. We will be sending a message via MyChart once we received the vaccine. 
• Infants under 2 months will be given doses at their next checkup. Infants over 2 months may schedule a stand-alone nurse visit or may wait for a next scheduled appointment in October/November 2023.